Full Circle with The Christi Reece Group

President Bryan Johnson - St. Mary's Medical Center - Full Circle With The Christi Reece Group - Episode 10

January 20, 2021 Bryan Johnson Season 1 Episode 10
Full Circle with The Christi Reece Group
President Bryan Johnson - St. Mary's Medical Center - Full Circle With The Christi Reece Group - Episode 10
Show Notes Transcript

In this episode, Christi talks with Bryan Johnson, President of St. Mary's Medical Center in Grand Junction, CO.  Hear what's new at the hospital, how the COVID crisis has impacted them and what is on the horizon for health care.  To learn more about SCL Health - St. Mary's, visit https://www.sclhealth.org/locations/st-marys-medical-center/.

If you prefer to watch your podcasts, check out our YouTube page for the video: https://youtu.be/firbVWhovLk

Speaker 1:

The Full Circle Podcast, compelling interviews and incredible tales from Colorado's Western slope, from the mountains to the desert, Christi Reece and her team hear from the movers, shakers, and characters of the Grand Valley and surrounding mountain towns that make the Western Slope, the place we all love. You'll learn. You'll laugh. You'll love with the Full Circle.

Christi:

All right. Welcome everyone to the Full Circle podcast. I'm Christi Reece, and I'm honored today to welcome our guest Brian Johnson, the President of St. Mary's Medical Center. Uh, Brian . Welcome.

Bryan:

Thank you. It's good to be here. Thanks, Christi.

Christi:

Yeah. So , um, obviously there's a lot to talk about with the current health situation, the pandemic, but let's start with a little background, cause we'd love to know more about you and how you got to grand junction. What was the path you took to get here and to St . Mary's?

Bryan:

Um, wow. That's, that's a great question. My path went from California to Virginia to here. Um, so I've covered the country. You know, I, I grew up in Northern California , uh, outside of Sacramento. I left there, Oh man. It's probably been 30 years now , uh, to go to school in Utah and then went to graduate school in Virginia. And then , uh , back in 2005 , I was recruited from Virginia to go back to Utah, to work with Intermountain Healthcare, where I spent the last 12 years , uh, working as , um, you know, first as, as what they called it operations officer in one of the facilities there. And then eventually took over as the CEO of especially hospital and then eventually became CEO of a , of , uh , one of their small community hospitals. And then in 2016 , um, it was looking for a change and, and , uh, saw the position out here. I'd been through grand junction several times and has been kind of funny because I used to drive from in college, my wife and I would drive from salt Lake to , uh , she grew up in Missouri and we'd drive to Missouri along I 70 and we'd drive through Grand Junction and take a little beautiful area out in the middle of nowhere. Right . So wouldn't that be fun? Yeah. And you kind of have these great cars, you drive along the Colorado river and you've got the cottonwoods. And as you know, it just sort of springs up out of the desert as you round the corner and in Loma and neck area. And it's always such a beautiful area that we always thought it'd be fun to live here. And , uh, the funny thing we didn't know the name of town was grand junction until I drove here , uh, for the job interview, I was like, Oh, this is that place we've always thought about. That'd be a fun place to live. And , um, it's all for us. This has been a really fun thing for us to move here. You know, we, we ever family and, and , uh, just kind of, and we both grew up in relatively small towns. My wife grew up in Moscow, Idaho, Idaho, and then in , um, Columbia, Missouri. And I grew up a town called Loomis, California, which is about 30 miles North of Sacramento and , uh, you know, small towns. And , uh, so for us getting out of a larger metropolitan area, like salt Lake was a real, a real benefit to us and kind of felt more like home. So we've just loved it here. Um, I've been here now for mobile for years and it just think is fantastic.

Christi:

It is a great combination of things, isn't it? Oh yeah .

Bryan:

Yeah. And we're very outdoorsy people, so it fits in line with that.

Christi:

Awesome. So I read that you had considered becoming a physician, but what attracted you to the other side of the medical industry to the,

Bryan:

You know, I, I grew up in healthcare . My dad was a healthcare administrator back in California, a hospital administrator. And so it's a little bit in the blood. Um, I , uh , I , I always have admired physicians and clinical folks and I've always been for me. My path I thought was going to be as a physician I , uh, applied for, and they got accepted to a couple of medical schools long ago, but , um, I had, I had some really good mentors while I was in undergraduate school , uh, where I was able to go and actually rotate and work with physicians. And I love the physiology of it, but there's a different mindset to being able to, you know, physicians just it's it's, it really is a different industry and a different personality to be able to , uh , do what they do. And , uh, and I realized then that, that wasn't what I wanted to do. Um , but , but I still wanted to be in the healthcare industry because I think healthcare generally in a community just touches people differently , uh, than any other industry out there. It's very personal. It's a , uh , it's much more intimate and that kind of fits, I think, a lot with how I like to work with my, with the teams and the staff and, and , uh , and so I wanted to stay in it. So I decided to go into the business side of , of healthcare. Um, I think that foundation was always good because I thoroughly enjoy working with physicians and with nurses and with clinical staff. It's a lot of fun for me to , to talk with them. Now, when they started talking about their specialties, I get out of my depth really quickly, but I find it fascinating and I really enjoy it.

Christi:

I do too . So my brother was a emergency room doctor at St. Mary's for a number of years. And I was always fascinating now I'm like, I know you can't share too much, but like what happened at the ER today? You know,

Bryan:

You can't share much, but the stories are pretty amazing. Yeah. Uh , you know, both the good enough .

Christi:

Right. Well, and I love

Bryan:

That. I love being the healthcare industry.

Christi:

Yeah. But I love what you said about the personal connection. I never really feel that with St . Mary's with the size of town that we have and the size of the hospital, I just really feel like it's such a personal place and there's a personal connection for so many people. I agree. Yeah.

Bryan:

You can't even go to Walmart in grand junction and not see somebody you either work with or someone who's been to St . Mary's and they want to talk to you about it. I think to me, that's fun.

Christi:

Yeah . That's awesome. So , um, speaking of the ER, department, we cover quite a territory with St. Mary's and the emergency services. Can you talk about that a little bit?

Bryan:

Sure. So we do, so we're a level two trauma center and I'm in a regional referral center. So what that means , um, is people who can't stay and they're in a smaller community hospital , uh, like Montrose or Delta or eating community hospital here in town or family health West. They have really good services there, but they don't have what you consider to be highly acute services. You know , they don't have for neurosurgery or heart surgery programs, that's really left up to a larger facility like St . Mary's to cover larger regions . And so they tend to transfer those patients here because we consolidate those services. And our , it it'll offer though, they're , they're kind of a precious resource to be able to have that. And so you consolidate them and then people transfer them here. Um, and so we get a lot of that business. Our , our catchment area is , is about 250 miles around. So we get patients that come from Cortez , uh, from Wyoming, from Eastern Utah, all the way up to Aspen. So our , our service area is really large. So that's, so it's not just an emergency service. We have a full trauma service and to support that we have a fixed wing and rotary wing Hilton , you know, we have helicopters and airplanes that, that fly people so that we can pick them up safely and bring them here and transport them. So we have all those services here, right here in grand junction that you would typically see in larger metropolitan areas. But we have it out here just because of our catchment area and the support we have from all the local and regional hospitals on the Western side.

Christi:

Yeah. That's wonderful. And you all have added some new departments have expanded. Some departments have added some amazing technology over the last few years about some of the great things that are going on there.

Bryan:

Oh boy. You know, you may have just tuned up the rest of your hour. Christine and I love talking about this stuff, you know, it's been a lot of fun. So when I first came on in , uh , to here in , in , in 2016, the new patient tower had already been built. That was the century tower, which is kind of what everybody sees when they come into town that the 16 stories of the building , um, and that really expanded our bed capacity and capability in the facility to kind of meet the needs of the community from a tertiary standpoint, you know, they called it the century tower , um, because most of the needs for a hundred years, probably a little optimistic , um, but really gave a great backbone to the facility. And that was, I think at the time it was about a half a billion $500 million project to do that, since that

Christi:

Time, that area, without that tower. Now I can't even remember what it looked like before. Yeah ,

Bryan:

No , it is funny. Cause it's the first thing you see when, when you come down through Loma, it's hard to miss. Um, but , uh, it really has been a great thing because we have most of our patient floors and we really are up to date , you know, in terms of, and we made it really flexible. The whole spine of the hospital is very flexible, so we can add new technology really easily. Whereas the older facilities is hard to do because you don't have the ceiling height clearances to put the technology in . Cause a lot of it's above the ceilings and you know, there's, I think there are 16 to 20 feet between what you see and what are the actual deck of the floor is. Yeah . So there's a lot of room

Christi:

There, duct work and wire

Bryan:

Ducting and all sorts of things. There's lots of room up there , uh , so that people don't see that actually supports the technology that we can put in this facility. Um, but since I came in 2016, the first thing we've added , we added just kind of going from 16 forward was we put $50 million into the heart and vascular Institute, which was what really was an expansion of our heart services program. And most people is hard to see from the West side of the building, but , uh, we, we had several , uh, cardiac catheterization labs or cath labs that were in the hospital. They'd been there for a long time. They were really small. And the technology around heart catheterization has changed so much that really do the , the room for those cats . If you were walking in the room and it was full of equipment, and then you kind of saw people's arms sticking out from the equipment as they tried to find room to work and really, and that's not the best environment. So we had to expand those and make those larger to accommodate all that new technology. Um, but we all along. And so that was an expansion and more of a renovation and kind of creating space that people were comfortable with and more family friendly, the real technology and service add to that project, which I'm really excited about was the , uh, was the addition of what we call hybrid operating room. And , uh, and the reason that's important is if you look at our open heart surgery programs and how they've been melding with , um, cardiology services over the years, you see more and more services moving away from that open surgery program to more of intravenous , uh, capability or minimally invasive work in order to be successful with that, you kind of need to have rooms designed to do it. And so as part of that project, this hybrid operating room was actually a , an operating room, but it has all the cardiac catheterization capabilities too , which has a lot of imaging and philosophy , uh, in it. But it's large enough to accommodate two teams of people. So one of the great additions that we were trying to build was called the , is the TAVR program, which was, is actually a trans arterial valve program. And , uh , what that means is we can re typically a heart valve in historically, you'd have to cut into the chest, open the heart and then replace the valve externally. And it's a really major surgery to cut into someone's chest and open the rib cage. Um, with the addition of TAVR , uh, you can actually similar to the catheter. You can actually take the valve up through the aortic, the aorta, which is the artery that runs through your body, supplying to your body and , and loop it through and actually expanded inside the heart. Um, without, with just a minor incision down in the leg , uh, yeah. In your leg. So they're running it all in there all the way up your backbone, basically, and into your heart. And , um, and the , but in order to make that be safe with that, you have to have a cardiac surgery team in the room and available to, to operate in case there's a complication with that TAVR. Or if it gets placed funny, or the heart goes into a deep bed or a fibrillation, then you have to be able to respond really fast to that patient. And to a certain procedure, you really don't have time at that point, the wheel, someone down the hallway, they've got the room ready to go, and you had to build a room big enough to do that. Now we have not had yeah. For two separate teams. So you've got a cardiac catheter team because the heart of the valve is placed by a cardiologist and their team. And then you have a heart surgeon and their team in the room waiting just in case something goes wrong. Um, and we haven't had any of those complications, but the real value of this , um, being able to do that is one, the room is very complex and highly tech and has the tech to do it. And you can actually watch the valve and be placed in the heart, had expanded , uh, with the, with the, with the imaging capability of the room. Um, but then it can be converted to , or immediately, but, you know, the real value is to the patients, you know, a heart surgery program when you crack into their chest. And then they get, you know, their recovery is very painful and long they're in the ICU for several days.

Christi:

And , uh , yeah,

Bryan:

And you know, it takes six to eight weeks to recover , uh, from the surgical procedure, even though the heart is stronger , uh, in the case of TAVR, we have people that they have their TAVR, they go into the ICU for observation and on the same day of surgery, they walk out of the ICU into patient floor. Uh, and they're discharged usually within a day because they're doing really well

Christi:

That's technology, it adds , and it's really exciting. Um, and did you have the specialists for these procedures here already, or did you have to hire a lot of new staff?

Bryan:

So we had the heart surgery team is already here because we have an open heart surgery program here at St. Mary's already. And valve replacement was part of, there was part of their repertoire that they could do. Uh , we had do because TAVR was new on the cardiology side , um, that we had to bring in cardiologists that were trained to do it. Uh, and they came in and actually what we found is we have some really good procedural cardiologists here in town already. And , uh , they wanted to be trained to be able to do it. And so when he brought cardiologists from , uh, really from the SCL system , uh, that were trained to do it already , uh, at St Joe's hospital in Denver, we brought them out here to train, to teach and train our cardiologists here in town. And so they've been working very closely with those teams. So we have now TAVR trained cardiologists that are based here in grand junction. And that's really one of the values of our system is we were able to bring that in, have that training be done, and now we have that skill and capability. Right.

Christi:

That's fantastic. Any other big projects coming up that you want to share with us ? We're doing one, right?

Bryan:

Yeah . We just kicked off of the replacement of our lab and pharmacy , uh , while there's those sound very exciting, they really kind of are , um, you know, the , it's a , it's another $50 million project and we're, we're, they're being replaced. And the really neat thing about it is pharmacy and labs are moving to automation and robotics. And , um, so with the new space , uh, w we actually had another little dull enough space into the, we can put a pharmacy robot in place. So if you go to the safety of , of drugs, if you were to walk into a hospital pharmacy and take a look around, you'll see lots of vials of medications that look almost exactly the same next to each other. And, you know, you in barcoding and really say the procedures around it. But as much as you add the human element to any process, you always introduce error , and we try and reduce that as much as possible. So in the new space, we'll be putting a pharmacy robot that actually will pick the medications that the patient needs based upon the order as placed by the physicians on the floor, the robot will pick the medication, drop it into a vial or a vial, but a canister basically that then is sent with the , with the pneumatic tube system up to the floor , uh , where the nurse would get it, make sure it's accurate. And it's the right, you know, they do all the checking and the double checking to make sure it's , this is the right medication, but really we're taking the human element out and make it that safer and faster. And it's, it's really, it's kind of a neat thing to be able to put that right here in grand junction is how these robotics, that people don't think the multi-million dollar machine is doing this to complex work, to create more safety.

Christi:

We are .

Bryan:

Yeah. And the labs doing the same thing, we're onto a fully automated lab that makes us competitive with Arab or, or any of the major , uh , labs that you see national labs were built , where we're able to have that capability right here in grand junction.

Christi:

Well, and it's exciting that you all have been growing and infusing money back into the community during these economic times for all of us.

Bryan:

Oh yeah. Well, if you don't mind, I want to talk about one more technology that I'm super excited about lately. Uh , so most people we've had robotic urology surgery for a long time and, you know , there's the DaVinci robots. Uh , we start with those couple of years ago. Now this last year we updated two of those robots. So we now have what they call their excise, which is their newest, greatest super-duper robot they produce. But we're using that now for general surgery. So if you walk into an OR, you'll see this spider , like machine hovering over the table, doing these really finite surgical procedures in a patient's abdomen , um, which makes it more precise. In fact, the , the, the capability of the, of the machine is well beyond the capability of our hands. The surgeon is driving it, but the surgeon is basically sitting in a booth across the, kind of across the room while there's robots over the patient. But what we're finding. So even on, you know , one of the, one of the greatest stories we've heard so far, I mean, we all hear about narcotic addiction and opioid addiction and the worry around that. And it's a real problem. But what we're finding is with these minimally invasive surgical procedures that these robots can do that that's hard to do with it with a human hand , uh, and granted the surgeons driving in total control of it , uh, more finding the patients, having, you know , um, uh, just basic hernia surgeries, which , uh , they've been doing outpatient for awhile , and they're coming out of surgery and not needing any pain medication outside of ibuprofen or Tylenol. So there's no narcotics at all for these patients and they're doing really well with it. Um, what a great way to not just save costs in the healthcare world, but to have a better clinical outcome and take , uh , make it a safer environment for our patients. Um, it's incredible. It's really fantastic. And we're doing that right here in grand junction.

Christi:

Bravo. That's amazing love hearing those. Um, so, and you , you St Mary's recently got some great ratings and those were reported in the news. Congratulations on that.

Bryan:

Thank you. Yeah, we're very excited about those. Yeah.

Christi:

And those were patient ratings. And just tell us a little bit more about what those mean to you.

Bryan:

So for us , um, you know, so what we're, we're, we're very proud of the work we've done. It's , it's called the leapfrog group. Um, it's not to be confused with the child's toy. Um, the leapfrog group came together in the 1990s as a group of , um, uh, basically fortune 500 companies that wanted to drive more transparency and accountability to healthcare and hospital systems , um, for employers. Uh, and so they started tracking publicly available data and reporting that on hospitals publicly, and then they would give a hospital, any visual individual hospital based upon their scores, an a, a, a C, a D or an F rating to get an a is incredible. You have to pour perform at the top. I want to say it's the , I think it was the top core tile or top 10th of the 10th percentile, like the night, sorry, I should say 90th percentile in order to hit those scores to get an a, you gotta be way up as a top performer. Uh, we identified this as a key goal several years ago, saying we need to be safe, a safe and effective place for our patients to come. There's no reason why , uh, someone in a rural market deserves any worse or less safe treatment than someone in an urban market. So we took those measures and really focused on how do we improve these scores and how do we get the outcomes? We need a lot of those around narcotic unit utilization. It was about putting the support systems in place in the hospitals to S to, to make it safer for patients where it comes to pharmaceutical barcoding and scanning to make sure we were accurate to reduce medication errors. Uh, there's a lot of work put into that over years, and now we've received our seventh, a rating in a row , um, with which , uh, that kind of puts St Mary's in the elite category for hospitals across the country, because , you know, people will go between A's and B's and kind of bounce back and forth , uh, in lots of seas across the, across the country, even on the Western slope, but to receive an AA rating is one thing, but to get that many in a row and be able to hardwire that process for safety into a facility, that's a lot of great work. I can't tell you how proud I am of our physicians and our clinical staff made that a priority. Um, they have just been fantastic and what a great, you know, that just shows, I think, commitment to a community that is not seen very often,

Christi:

And those of us that live here and have had the opportunity or the unfortunate opportunity sometimes to be in the hospital and St. Mary's , um, it doesn't feel like a little rural hospital. I mean, it is a , uh , just a high-class facility and everybody there that I've ever come in contact with has just been amazing. So,

Bryan:

Yeah. Yeah. And we're very proud of it. We do a lot of great work here at it's right here, local close to home. Yeah.

Christi:

So , um, I read an article that you penned , um, about , uh, hoping to lower that one of your goals was to lower healthcare costs. I mean, that is definitely a concern for a lot of consumers. Um, how do you tackle a big challenge like that? I mean, that's a , that's a pretty lofty goal. And how do you do that from your perspective?

Bryan:

You know, I have to tell you, this is something I was brought up. I, before coming to grand junction, I worked for two really high quality organizations that have been kind of on the leading edge of quality care and cost reduction. So , uh , Sentara healthcare back in Virginia, I worked with them for about seven years , uh, and had a great experience with them. And they were kind of on that, on that leading edge of how do we improve quality and standardization of work and drive costs down within a market? Uh , yeah , they were, they were there , uh, what I would consider one of the top tier organizations in the country, they wake right up there with, you know , uh , mass general or Cleveland clinic or the Mayo , uh, in terms of their capability. And then after that, I was able to go to work with Intermountain for Intermountain healthcare in salt Lake , um, for 12 years. Um, and Intermountain is internationally recognized as a cost and quality leader across the world. Um, you're talking about , uh , an organization in right next door to us that runs a cost per capita for the state of Utah, similar to that of Norway , um, which is unheard of in the United States. Um, you know, it is by far and away the lowest cost organization or place to live from a healthcare perspective in the country, but they also have some of the highest quality scores of any organization in the world. And yeah, it's really as well , because what you would consider to be a premier healthcare organization, not only in the country, but in the world. Uh, and they're, they're , they've been on this journey for years and years and years since the 1970s. And , uh , so I, I had the opportunity to work with them for 12 years and led a lot of projects. There were, they kind of ingrained it in you that this is , or this is kind of your civic duty. Our job is to provide really good care at the lowest appropriate price. And , uh, and, and, you know, and they had a lot of data resources. They were some of the first , one of the first organizations in the country that put together data resources to support clinical decision-making that would allow for that type of interaction. The work is very , it's simple in concept, but very complex when you get into it. And the way we look at it is you kind of have to pick An area to work on because there's, there's, there's costs everywhere that you want to focus on, but the way you look at it is you kind of say , okay , uh, imaging costs on inpatient silence . It's a relatively , relatively simple one. Um, and you look in the hospital, you say, okay, we do x-rays on the patients in the ICU. How do we do we, do we do the same amount or more amount? Or , or do we have physicians that do it differently than most each other within the hospital? And it turns out every hospital across the country, they do, you have some physicians that order, lots of them, and you have someone to dorm order room , any of them. And so you get that data and you bring the physicians together and say , okay, look, we would, and I'm just doing that mostly on the x-rays cause that was , this was kind of the funnest ones. That was one of the first ones we did when we were here. But it gives you an example of it turns into millions of dollars. Uh, I think over the past four years, we've been able to cut out almost $45 million of expense at St . Mary's alone, but these kinds of projects, and then we're able to pass that onto our consumers and which, which we've been doing. Um, but then , uh, you know, so take x-rays in the ICU. Uh, we found that some physicians order a chest x-ray on a patient every day that they're in the ICU and some physicians order it every three days that they're in the ICU. And we brought the physicians together and say, help understand why you're doing that. And by the way, we looked at all the other hospitals within our system. And we find that we take a lot of chest x-rays on patients in the ICU relative to them . We do more, almost double what everybody else does. And then if you give that information to physicians, they can say, well, why? And, you know, so the physician sat down and said, well, you know, we do this because this is how I was trained to do it. And I just kind of always done it. And then we asked the question, well, that's great. Uh , and , and , and they'll say works really great. I've never had a complication as long as I do it this way. And it was like, great. Well, when was the last time you looked at one of those x-rays , um, occupation in the ICU? I was like, Oh, it's very important to us diagnostically. But our data system that we have at St Mary's is Epic, which is one of the, one of the premium , uh , electronic healthcare record systems in the world. Um, and we always say, you know, just so you know, we pulled some information on your patients and you haven't looked at one of these x-rays in literally years . Um, and so you're not using it for diagnosing the patient. It's not diagnostically relevant. And we did it by type of by type, by type of , um , I'm oversimplifying this a little bit because you have to break it down by type of admission. But , um, as a physician is talking about it, they realize, Oh yeah, I really don't look at those. Well , why do you do it? Well , it's cause I've always done it that way. And it's worked really well. I've never had a complication as long as I do it. And I say, well, let's, let's try not doing it. Um , and they'll say, sure, well, because they have partners that don't do it. They talk to their partners and they get clinically comfortable with it and they don't do it. And then all of a sudden they realize , yeah, I really don't miss doing that. And it doesn't make a difference to us. And then we just take it out of the protocol. It's no longer part of the process. And you can do that. Pharmacy imaging just

Christi:

There's so many departments and so many , uh, so many, it's just huge. I mean, I can only imagine trying to take each piece and find some areas to cut back.

Bryan:

And it adds up to millions and millions of dollars. Well , one of my favorite stories came out out of our lab or one of our, one of the lab techs. We're looking at the vials we use in the lab and we have these purple ones and we have yellow ones. I don't know what the difference is between the two, but then we, all the ones are cheaper. Um, but we use the purple ones and , and she kind of said, why don't we use the purple ones, you know? And there was like a lot of others there, right? Why don't we try to use the yellow ones? And they're about, you know, you're talking to a difference of a dollar versus 10 cents. And , uh , they started using the yellow ones, ones with the old labels on them. They started using those, Oh , these were great. We'll just keep using these well, that turned into about $50,000 with a savings for the hospital, because that's just what we did. And that sort of stuff lives everywhere in the hospital. And we've been, we've been steadily just on a routine basis, chipping away at it. And it adds up

Christi:

That kind of thing lives everywhere in every business, right? There's always ways that if you dig, you can find somewhere to save money, the organization, the size of yours, that's gotta be a tremendous job.

Bryan:

Yeah. And we get out there, our nurses and our physicians looking at it, and now we're really trying to move towards how do we standardize our workflow. So we've kind of knocked away the, the low hanging fruit on that one. And now we're looking into, let's do things the same way , um, and getting physicians to the information they need to say, okay, if I have some , if I have a patient with sepsis, let's treat the patient this way, because you'll find that they do have three different physicians . You have three of the ways of doing it, and you get them to think about how to do it the same way. If you get them to do it the same way, the costs that you have , the cost goes down and the quality goes up because you now implemented a standard process. People in, in , in manufacturing, you've been doing this for forever and healthcare . It's, it's been, it's been slow to adopt, but so it was very similar principles that we're applying here and having our physicians working on how do we standardize processes and do things the same way and treat and treat most diseases, you know, do like 85% of most diseases. They're all, they all get treated the same way. And keeping physicians really focused on the 15% that don't behave the same way, because there are variations to it.

Christi:

But the technology has really changed that too. Right. I mean, just having the ability to share information from doctor to doctor, hospital, hospital , um, there's so many new things that are coming all the time that are making things more efficient.

Bryan:

That's right. And we've been able to make those investments. That's been, one of the values of our system is we have the financial resources to make the kinds of investment necessary to do that kind of work. A lot of organizations don't have that. Yeah.

Christi:

Great. Well, let's turn to the pandemic and COVID, I'm sure everybody wants an update, but the first question I want to ask is how's the morale at St. Mary's and how are your healthcare workers and staff doing? I mean, it's got to have been just an incredibly challenging time for everybody that works in the healthcare industry.

Bryan:

It has been, you know, not just from a , uh , a work and productivity standpoint, there's a lot of fear around this. So if you go to the first part of the pandemic, there's a lot of fear and concern about what this means. Plus we had shortages on personal protective equipment. Uh, that really was nerve-wracking . I have to tell you , um, I've always enjoyed working with physicians and nurses. I think they're fantastic people. And I think they're , I've always believed they're all heroes, but in 2020, they all demonstrated so clearly how really, how would they, how much they really do care about their communities? I , uh, I've always had a great deal of respect for them , but I have to tell you, it has just increased , uh , tenfold because I've watched people do what I consider, be heroic things on a daily basis. First off, I want to say, thank you that , uh , our, our clinical staff and our medical staff and our team and our technical staff that supports them in the hospital because they have been absolutely amazing and , uh , and truly deserve what I would consider , uh, the position of hero

Christi:

In my mind, 100%. Um,

Bryan:

I would tell you that , uh, they are tired. They are very worn out because it hasn't been there. Hasn't been an off switch, you know, it's, it's constant. And then you add to the fact that it's not just a function of being busy , um , but there's no reprieve because you have staff that, you know , get exposed to COVID, then they've got to go home, be quarantined, and then wait for the test to come back, which exacerbates the problem. So we have these people that have just been , uh , just been, you know, for lack of a better way of saying it kind of run into the ground. It's not intentional, you know , we don't want to do that to our staff, but there's no, there's no replacements or alternatives. I mean , we've, we've looked at hiring temporary staff to come in and help provide , uh , shift coverage or kind of backfill the needs. They can take a break, but the , you know , even the travel companies that hire these people, they have 20,000 openings today that aren't, that aren't filled.

Christi:

Yeah. I was going to say, where do you get temporary staff these days ? Everybody needs that.

Bryan:

None, there aren't any, everybody got the same problem. And so really these people are just coming in day after day, filling the needs. And , uh, and we're grateful for the fact that we've taken a little dip in the census , uh, recently of COVID patients. So we've been able to give people a break. Uh , but, but again, now we're starting to see that creep up a little bit again. So we're getting right back into it. Um, I'm , I'm really hopeful for the vaccine to be able to start to knock that back down to the community, again, as that grows mostly because our staff are tired , um , they're, they're worn out and they have every right to be

Christi:

Well. And I think some people forget, it's not just about the people that have COVID and are entering the hospital. It's all the people that need other services at the hospital and how COVID is affecting everything there. I mean, it's just an added layer. So one layer ,

Bryan:

Yeah. COVID comes in and there are very sick patients when they come to the hospital, but didn't stop all the people out in the desert, playing on their motorcycles, get injured that need treatment. Do they have to be taken care of? Yeah , that's all , it just hasn't there hasn't been a reprieve. Um, usually health care has a seasonal aspect to it. So you kind of have ups and downs to it. 2020 has not proven to be that way. And so , um, it's been, it's been hard on him . I would say the morale is pretty good. Generally speaking, because most people are understand that this is a unique circumstance, you know, and people are in, and , you know, we put a lot of support structures and added any resources we can to them , uh, to help them, you know, possibly we've done crisis pay. Plus we brought, you know, people that could take on additional responsibilities away from the nursing staff, particularly to allow them to focus on the things that they have to do as nurses. So we've done a lot of work around that, but it's still just not enough. And so they're just, they're just stretched.

Christi:

So what is the vaccine situation here in grand junction at this time?

Bryan:

And , you know, it's very similar to, to everywhere else in the country. There's a lot of people who want it and not enough to give it to them. And so we're getting our allocations and I have to tell you, this is where the collaboration between the hospitals and the department of health has been really good. Um, we've been able to, you know, if you look at , um, I think the numbers I saw today, we were in a meeting this morning with all the hospital CEOs and , uh, and Jeff Kerr from CDPH. I think we vaccinated 4,700 people in, in Mesa County between the, between the hospitals that are doing it. Um , as family health, West County hospital St Mary's and the health department, we have plenty of capacity to continue to vaccinate people , um, between our sites. We're able to meet that , that demand really easily. The real limiting factor is the amount of vaccine. And so when we get it, it goes really smooth. Um, and people were going through and getting it done, but it's, it's just like a relative , there's just not enough vaccine to get to everybody who wants it.

Christi:

And do you have any , um, anticipation of when that will improve or is it just, you just don't know, and it is, you're just waiting. And

Bryan:

Mostly we're just waiting

Christi:

From the sky unannounced .

Bryan:

We received 2300 doses yesterday, yesterday, and we were notified of that, I think on Monday that we were going to get them. And now those, those appointments for those 2300 are all booked. It just doesn't take long. It's a real smooth process once we have it, you know, I think we'll continue to, as manufacturing continue to improve and it scales up, we'll see that just like, there's no different than what we saw with PPE in the first part of the, or the back of the vaccine yet have a big shortage. And it was really tight. And then as manufacturing picked up and , and got around to it , um, it got more available and then B it wasn't , uh , it wasn't an issue and we'll see that same thing happen here too. I don't know the timeline to it too . I think it's, I think there's a lot of speculation out there. Um, when we , our focus has been really on when we have it , how do we get it out as efficiently to the people that needed it as possible?

Christi:

And w w what do you see for , uh, um, how we compare to the rest of the state , the rest of the country? How are we doing in comparison from

Bryan:

The vaccine standpoint?

Christi:

Yeah. And the COVID cases. Yeah .

Bryan:

You know, we did really well up front with, with COVID. So I'll go back to, COVID going back to like , um, March and April, this last year, we were doing really, really well. We knew it was going to get the area, you know, we're a little more isolated, smaller, and there was less sort of travel around. We knew it was going to hit, but we knew it would be delayed only because of it . We're just a more isolated area we have done really well. Now we've had our patches where, you know, the , like this fall, we're starting to ramp up again. And we, from a relative standpoint, we really kind of hit a higher threshold long . That was because of some of our , uh , of some of our nursing homes, having gotten some infections in them, which hat , which was expected to have happened and that kind of cycles quickly. And so we saw that spike in that went back down. I think our experience outside of, I think the numbers have been very similar in terms of percentage of population that you see anywhere else. The real difference. I think that we have seen versus some of the other areas of the country is that the, the collaborative spirit between the organizations here in Mesa County, actually across the whole Western slope has really provided a real asset to us that I don't think other entities or areas of the country that have been able to figure out how to do, you know, early on in the, early on in the pandemic , uh , we were able to get together with all of the other hospital CEOs and, and with the counties and start identifying where we had bed capacity and bed shortages , uh, and ICU and bents . And we came up with a process internally before the state was even really doing this. We decided, listen, we understand that ICU's are a precious resource and ventilators are precious resources. We want to make sure that , that we reserve those for the people who really need them. So when the patient shows up with COVID, who doesn't need them in the hospital, let's make sure that patient stays at lower acute hospital unless they progressed to needing the hierarchy of facility, which would be St Mary's in the Western slope. And all of the hospitals were really engaged with that. So they kept a lot of these patients that didn't, or in other areas, they kind of just took those patients and transferred them to the hierarchy facility and plugged up all the beds. Uh, and, and then they were having to be on divert. And then a lot of challenges around trying to get those patients placed. I'm not going to say it's been perfect. Uh , but , uh , but we've had a lot fewer issues. You know , we've been able to move patients between our facilities. We've had patients that were lower acute that came to St . Mary's that we were really tight , uh , on our bed capacity and were able to call other facilities like Delta or Montrose . And , um, and we were able to move those patients that could go from here to that facility, freed up the beds for the traumas and for the high acute patients that came here. So we really, the level diversion and bed capacity issues has not been anywhere near what we've seen the challenge in other, in other areas. So it's been a real benefit. And, you know, it makes me really grateful to be honest with , uh , uh, uh, being here at the San Mary, you know, you realize that we're very independent interdependent as, as a healthcare system. And I'm really grateful to all the other hospitals in the , on the Western slope, who've kind of said, listen, we're going to step up and ready to play as a collaborative group of hospitals and an organization . It's not just hospitals, we're talking about post acute centers. And I say , hospitals, bunting , I shouldn't say healthcare in general, where we've kind of stepped up and said, how do we work together for the betterment of our community to take care of our patients so that we can minimize the effects that we've seen happening elsewhere. Um, but I I'm really proud and grateful for all of my counterparts, all the other facilities and their medical staffs that have really kind of grabbed this bull by the horns, it to make it work. And so we really have had what I would consider be less of an impact on us than other communities have had. We haven't had near the extremes that we've seen in papers like out of New York. And we haven't had that much of an issue because we've been willing to work together to work through problems. And it's just been a real, it's been a really satisfying time in my career to watch people that come together like that.

Christi:

That's wonderful. And I think that , uh, um , you know, reading the newspaper and seeing that collaboration has meant a lot to the community and the health department, I think has been doing a great job and keeping it

Bryan:

And his team have just, you know, their heroes too . They've been absolutely outstanding.

Christi:

Yeah. So if you could , uh, make any kind of prediction or even a hope, like what , what do you hope is the best case scenario for getting through this pandemic? Uh, I know you can't speak to, you know, I mean, it's a worldwide pandemic, but , um, what do you hope happens with the , uh , vaccine and what does that timeline look like to you?

Bryan:

You know, I, I hate to speculate on that one, Christi, I, there are a lot smarter people with that know , that know more than I do about this, but our focus has been on how to be operationalized and take care of our community. Um, you know, I do think we're going to , I do think 20, 21 has got a lot of hope to it. You know, we're seeing a lot of what I consider to be a really good steps towards the vaccine getting out. I know there's a lot of worry about the second strain of, of COVID coming out and hitting the, hitting the United States and, and hitting us again, which it will , um, that's to be expected. And we're just trying to focus on, let's get as many bags to people vaccinated as we can. Cause that does less than the kind of that it does improve the odds of herd immunity, which we've heard a lot about to do kind of improve that the R R the probability of success through it. Um, I can tell you that those , the health care organizations across the Western slope, we're still working really closely together. I don't want to speculate on a timeframe. I wish I could give you that one, but I honestly don't know. Um, there's a lot of, there's so many unknowns in the process. I don't think anybody has a real good read on what's going to happen. So our focus has really been on how do we operationalize and how do we remain as efficient as possible and take care of our community?

Christi:

I think the , you know, the general public would just wants to know when can I travel again? When can I throw it at them ? I don't

Bryan:

Blame anybody at all. I just don't have a good answer for

Christi:

Him . Yeah, I understand. I understand. Well, Brian, we so appreciate you talking to us today. Um, any parting thoughts you'd like to share with us about St Mary's or anything else?

Bryan:

So I , I , I want to just make a kind of a call for, you know, I know there's a lot of people that have concerns about the vaccine as it rolls out, you know, there's a lot of do , or don't want to tell yet, or they're concerned about it. Uh, we faced that even here in the hospital with our own staff , um, and that's to be expected because it's a new vaccine. Yep . Um, the last thing I'd like to say is, you know, the FDA has done a good job of reviewing this and it's a safe vaccine. And one of the best things that we can do for the public safety is when it's available and you can go get vaccinated in the meantime, wash your hands, wear your mask, you know, do the social distancing necessary . Cause we, it , the numbers of the data's out there, you, you do those things and it does slow the spread, which makes it so that we can take care of the patients that, that get it, or , or that taken care of the community. So I would ask, I know we're all tired of hearing about it. I'm tired of talking about it and I'm tired of wearing my mask too, but you know, do those basic things and we'll get through it and we'll get through it stronger together. And I would highly encourage people to be willing to take the vaccine, you know, go and get it done. It really will. It is a safe vaccine. Uh, we've seen that and I I'm a health care worker. I got my shot and I haven't go with , I haven't grown a third arm yet.

Christi:

Yeah . Your hair fell out. I think

Bryan:

That unfortunately happened about 20 years ago. And my last plea is, you know , listen to her. Listen, I think our, our, our healthcare leaders, the department of health is right on the money with this. Um, we can do this

Christi:

Well for those people that want to get back to normal and they want to go on vacation and do all those things. That's the way. Right, right. Get the vaccine that's available to you.

Bryan:

That's right. And in the meantime, and even afterwards wear your mask, wash your hands and socially, just as I'll keep our businesses open, that'll keep our economy going. It's a sacrifice, it's an inconvenience, but it's what we need to do to make it all happen. Yeah.

Christi:

Brian , thank you to you and everybody at St . Mary's and in the healthcare industry here in the Western slope and everywhere that are taking care of all of us , uh, through this really challenging time , uh, it's been an incredible year. And , uh, here's hoping that we get through this in 2021 together. Thank you . Christie has been a pleasure talking to you and , uh, thanks for allowing me to take the opportunity to talk to you . You bet. Thanks everybody for listening and watching the Full Circle podcast, Bryan Johnson of St . Mary's Hospital. And we'll talk to you soon.

Speaker 1:

Thanks for listening. This is Christi Reece signing out from the Full Circle podcast.